| NPI | 1447795604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: OH P.7524) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: OH 7524) |
| Enumeration Date | 2016-12-27 |
| Last Update Date | 2021-02-12 |